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Order Number:SAP EC Notification Number: <br />^^^^^^^^M <br />•I Electi <br />fff * <br />P» °' <br />SECTION 1 -TO BE COMPLETED BY FIELD PERSONNEL <br />Electric Corrective <br />Work Form <br />OVERHEAD <br />*FDA Description <br />(Enter highest priority Facility/Damage/Action from back of Form): <br />Facility: <br />fU <br />Damage:Action: <br />*PRIORITY <br />D A - Emergency <br />D B - Urgent <br />DE-12Months <br />Next Insp <br />*Reporting Information: <br />'Identified in Field By: (PG&E = LAN ID) <br />*LAN ID <br />'Identified in Field On: <br />'Recommended Repair Date <br />* I J /l <br />MM DD YY <br />It I I ± I I' <br />MM DD YY <br />Work Type Code: <br />'E Crew Size <br />de: <br />*GC rew Size <br />'Estimated Elec Labor Hrs: <br />Estimated Gas Labor Hrs: <br />Reference Information (Circuit & SSD Required at entry in to SAP - to be verified by Clerical if unknown in field) <br />'Plat Map: 'Circuit:'SSD:Pole # (Requiied if numbered Pole)Equipment*: Meter*: <br />|6^C76t733^ <br />Location Information ("Location Number required for Compliance Inspection or Patrol) <br />'Location #: 'Street Address: <br />-*-s K.X. <br />Cross Street:'City: <br />rf^ <br />"Main Workcenter: <br />^i* t-£- 1*-^ 3 7 , <br />Latitude /Longitude: <br />7 .r i ' 1 |,k 1 *4 9" J| ' S >'-> \ in Field During (Required • Check One): Secondary Field Identification (Check all that apply): <br />C3^t5omplianee Inspection D Trouble-Work D Equipment Inspection CD-^oint Pole D Customer D Substation D PG&E/QA Audit <br />n Compliance Patrol D Crew-Work D Pole Test & Treat D Other D UWF (Urban Wildfire Area) D Work Verification D CPUC Audit <br />D Infrared (Check only if attaching IR Data Sheet) D SmartMeter™ <br />^Conductor Type (Required - Check One}: <br />LTPrimary D Secondary D Service D Service / Streetlight Conductor <br />ERR Pin (Reference Only) D PIN #: <br />OIS: (Required if Outage Related) D OIS#: <br />Field Condition - Exposure (Check all that apply - provide supporting comments if addition information is needed for field): <br />D High Public Exposure OR Public Gathering Area (school, park, mall, etc.) D Cpjrunercial / Industrial Customer D Extreme or High Fire Risk Area <br />D Residential Area D^Remote (Ag or Low Populated Area, etc.) D Waterway <br />Field Condition - Accessibility (Check all that apply - provide supporting comments if addition information is needed for field): <br />D N£ Road Access LI Seasonal Work: (Dry, Harvest, Snow, etc.) Cannot Work From / To / <br />Snaffle Control Plan Required <br />D Customer Issue (will not allow PG&E on property, etc.) D City Moratorium: Cannot Work From _ <br />D CGI (Can't Get In): Dog, Locked Gate, Etc. MM/ DD MM/ DD <br />D Rear Easement D Special Circumstances: <br />'Is a Clearance required? D Yes D No ET Unknown Q^TA/LTA D Flagging Required? D USA Required? <br />*Field Comments (Describe the work required and the equipment and materials needed. For example: Special tools or equipment, any unusual conditions, <br />special circumstances, and supporting comments related to Exposure or Accessibility): <br />/ DD MM / DD <br />./ To / <br />Digital Picture*: <br />Bird Report Event Log #: "Bird Incident No.: (Required for BGR/57R Raptor Work): <br />SECTION 2 - TO BE COMPLETED BY CREW PERSONNEL IF WORK IS COMPLETED IN FIELD (EMERGENCY OR SAME-DAY): <br />Completed By (LAN ID): <br />Signature: <br />Completed by T-Man?Completed On:Actual Labor Hours: <br />/ verify that all maintenance on this notification is completed *Reviewed By: <br />DD YY <br />Compliance Department Review <br />"Reviewed On:I I <br />Version 1.6, Effective 6/26/2012